Colorectal Cancer News

Is a Colonoscopy More Effective in High-Def?

Some medical centers are marketing their high-definitioncolonoscopes, which they say will detect more pre-cancerous polyps. Several recent studies have found a small benefit to high-definition colonoscopy over the standard variety, but gastroenterologists say physician technique is more important in detecting polyps than equipment.

While the colonoscopy saves many lives, polyps are often missed. "There is a growing consensus that we need to improve the overall quality of colonoscopies and high-definition is one of the technologies that may help us do that," says Michael B. Wallace, chief of gastroenterology and hepatology at the Mayo Clinic in Jacksonville, FL.

Many hospitals now use high-definition colonoscopes, which are sold by a number of companies. The image is sharper and more detailed, and could potentially help clinicians find polyps they would have otherwise missed.

Clinical trial results have been mixed. An 850-person study by researchers at the Cleveland Clinic found that HD colonoscopy did not improve the identification of individuals with either benign polyps or adenomas. The study was published online last August in the journal Digestive Diseases and Sciences.

A 2,430-patient study by researchers at the Mayo Clinic in Jacksonville, published earlier this year in Clinical Gastroenterology and Hepatology, found adenomas in 28.8% of patients examined with high-definition colonoscopy, compared with 24.3% in those examined with standard colonoscopy. Polyps were found in 42.2% versus 37.8%. The scope tested, from Olympus, had both high-definition and a wide-angle view.

HD colonoscopy doesn't currently cost patients or insurers more than standard-definition scoping. Over the long run, the more expensive equipment adds only a few dollars to the cost of performing each procedure, says Douglas K. Rex, director of endoscopy at Indiana University Hospital in Indianapolis, but the additional polyps found may result in more biopsies, raising costs.